Payer Contracting and Credentialing

Our Managed Care contracting and credentialing services is designed to streamline the complex and time-consuming process of negotiating contracts and obtaining credentials for your practice which enables you to expand your portfolio of accepted payers, allowing you to reach a broader patient base. This expanded network enhances your market presence and fosters stronger relationships with referring providers, as they are more likely to send patients your way when they know you are accessible through a wide range of insurance plans.

Our service not only improves your operational efficiency but also enhances your practice’s ability to secure favorable terms and participate in the right networks, ultimately leading to better financial outcomes and a stronger competitive edge in the healthcare marketplace.

Contracting and Credentialing services include but not limited to:

  • Initial Credentialing and Re-credentialing for Providers

  • Provider Enrollment with Insurance Plans

  • Contract Negotiation, Revisions, and Amendments

  • Payer Contract Dispute Resolution

  • Network Participation Analysis

  • Contract Implementation Support & Performance Monitoring

  • Credentialing for New Locations or Expanding Practices

  • Credentialing Audit and Compliance Reviews

  • Consulting on Payer Mix Strategy